Cellulitis in teenagers

Overview

Cellulitis is a bacterial infection that happens deep inside your skin. It makes the skin red, swollen, hot, and painful. It can happen anywhere on the body, but often affects the legs, arms, or face.

Cellulitis is fairly common in teenagers, especially those who are active in sports or have skin conditions like eczema or acne.

It affects teenagers of all genders. You are more likely to get it if you have a break in the skin, a weakened immune system, or a condition like diabetes.

Symptoms

Common symptoms

• Red, swollen, warm, and tender area of skin that can spread quickly
• Pain or discomfort in the affected area
• Sometimes a fever, chills, or feeling generally unwell

Symptoms in children

• The same red, swollen, and warm skin as in older teenagers
• They may be more fussy or irritable than usual
• They might complain more about pain or not want to use the affected limb

Symptoms in older adults

• This section is not relevant for teenagers, but for older adults symptoms can include confusion or a rapid drop in blood pressure.

Causes

Main causes

• Bacteria (usually Streptococcus or Staphylococcus) entering the skin through a cut, scrape, insect bite, or cracked skin
• Having a skin condition like eczema or athlete's foot that leaves skin cracked or broken
• Piercings, tattoos, or injections that are not properly cared for

Risk factors

• Playing contact sports or spending time outdoors without protecting cuts
• Having a weakened immune system (for example, due to chemotherapy, organ transplant, or HIV)
• Being overweight or having lymphoedema (swelling from a damaged lymph system)
• Using intravenous drugs

When to see a doctor

See a doctor urgently if:

• If the red area on your skin gets bigger or more painful quickly
• If you develop a fever or feel very unwell
• If you have a condition that weakens your immune system

Book a routine appointment if:

• If you notice a small patch of red, warm skin that does not improve with basic first aid after a day
• If you have recurrent infections and want to discuss prevention

Diagnosis

Your doctor will look at your skin and ask questions about your symptoms and history. They might touch the area to check if it is warm or swollen.

Tests that may be done

• Sometimes no tests are needed – just the doctor's exam is enough.
• If the infection is severe or keeps coming back, the doctor may take a small sample of pus or fluid to send to a lab.
• Blood tests can check for signs of infection spreading through your body.

What to expect at your appointment

Your doctor will usually start treatment quickly. They may prescribe antibiotics and ask you to keep the area clean and elevated. They will explain what to watch for and when to come back.

Treatment

Cellulitis is treated with antibiotics. Most people take them by mouth for a week or so. For severe infections, antibiotics may be given through a needle in the hospital. With treatment, you usually feel better within a few days.

Self-care at home

• Keep the infected area clean and dry.
• Rest and elevate the affected limb to reduce swelling.
• Take over-the-counter pain relievers like paracetamol or ibuprofen, if recommended by your doctor, to help with pain and fever.
• Finish the full course of antibiotics even if you feel better.

Medical treatments

Your doctor will prescribe an oral antibiotic that targets the bacteria causing the infection. They may also take a swab to check which bacteria are present. If the infection is severe, you may be admitted to hospital for IV antibiotics. Always follow your doctor's advice on how to take the medicine and for how long.

When is surgery considered?

Surgery is rarely needed for cellulitis. In very rare cases, if a pocket of pus (abscess) forms, a doctor may need to drain it. This is a minor procedure done with local anaesthetic.

Living with this condition

While you are being treated, you might need to take time off school or sports. Keep the area clean and watch for worsening symptoms. You can usually return to normal activities after a few days of treatment.

Lifestyle tips

• Keep cuts and scrapes clean and covered with a plaster until they heal.
• Moisturise your skin if it is dry to avoid cracks.
• If you have eczema or athlete's foot, treat it properly to reduce the chance of infection.

Diet and exercise

Eating a balanced diet with plenty of fruits, vegetables, and protein helps your immune system fight infection. You can do light exercise if you feel up to it, but avoid anything that rubs or hurts the infected area until it heals.

Mental health and emotional wellbeing

Having cellulitis can be stressful. You might worry about how it looks, missing school, or the pain. It is normal to feel anxious or down. Talk to your parents, a school counsellor, or your doctor if you need support.

Prevention

You can lower the risk of cellulitis by taking good care of your skin. Keep any cuts, scratches, or bites clean and covered. If you have a skin condition like eczema, keep it under control. Avoid sharing towels, razors, or other personal items.

Vaccines

Some vaccines can prevent infections that sometimes lead to cellulitis, like the chickenpox vaccine and the pneumococcal vaccine. Check with your doctor that you are up to date on routine vaccinations.

Screening programmes

Screening is not needed for cellulitis. But if you have recurrent infections, your doctor might test your blood to check for underlying conditions.

Complications

If left untreated

• The infection could spread into deeper tissues or the bloodstream, causing sepsis (a dangerous whole-body infection).
• It can lead to an abscess (a pocket of pus) that needs draining.
• Rarely, it can cause long-term damage to the lymph system, leading to swelling in that limb.

Long-term outlook

With early treatment, almost all teenagers with cellulitis recover fully within one to two weeks. Serious complications are very rare. Taking antibiotics as prescribed and following your doctor’s advice gives the best chance of a quick, complete recovery.

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